Panic Disorder
Panic disorder is a type of anxiety disorder that is characterized by repeated panic attacks. Someone with panic disorder may experience sudden, unpredictable panic attacks that result in intense feelings of fear or dread. The panic attacks can be so frightening, even resembling a heart attack, that the individual may become fearful of triggering another one. This can then lead to isolating behaviors that cause impairment in several areas of life.
About Panic Disorder
According to the Anxiety and Depression Association of America, 2-3% of Americans struggle with panic disorder. Panic disorder usually emerges in early adulthood, although some children may experience a form of panic disorder. Agoraphobia, or the fear of being in locales or situations where they feel trapped, can often coexist with panic disorder, only enhancing the disruption in daily functioning. About 50% of those with panic disorder have symptoms of agoraphobia.
It is still not known what causes panic disorder. There appears to be a genetic component, as panic disorder can run in families. Another factor may be due to brain chemistry, with an irregular fear response to situations or events that are considered much more dangerous than they really are.
Signs and Symptoms of Panic Attacks
When a panic attack strikes it usually comes from out of nowhere and with little warning. In fact, it is this unpredictability that elevates the anxiety associated with anticipating the next attack. The symptoms are so disquieting that individuals with panic disorder will begin to practice avoidance behaviors and self-isolate in an effort to avoid possible future panic attacks. This can have significant negative effects on all aspects of daily life.
The symptoms of a panic attack include four or more of the following:
- Rapid heart rate
- Trembling or shaking
- Shortness of breath
- Heart palpitations
- Chest pain
- Chills
- Sweating
- Dizziness
- Headache
- Fear of losing control
- Nausea, diarrhea, vomiting
- Choking feeling
- Numbness or tingling
- Feeling detached from reality
- Intense dread, feeling threatened
- Fear of dying
Panic attacks tend to emerge quickly and without warning, but also dissipate fairly swiftly.
How to Manage a Panic Attack
If diagnosed with panic disorder it is good to have a toolbox of coping skills in place. In anticipation of panic attacks, become familiar with the following management strategies:
- This too shall pass. Remind yourself that it is temporary, not life threatening, and try to ground yourself at the onset of the panic attack.
- Don’t fight it. Try not to fight the panic attack, but instead accept you are having one and reassure yourself it will soon pass. Replace negative thoughts with self-affirming thoughts, such as you are in control.
- Breathe. Deep breathing techniques involve breathing in through the nose slowly for 4 or 5 seconds, holding breath for 7 seconds, and then exhaling slowly. Repeat 5 times.
- Get help. Don’t be afraid to get help if you feel you need it, even if it is just to get outside in the fresh air. If you are concerned the panic attack is out of control, ask someone to get you to the hospital for evaluation.
U.S. adults are estimated to experience panic disorder at some time in their lives
U.S. adults are estimated to have had panic disorder in the past year
The results of studies on manualized CBT suggest that a substantial proportion of patients with panic improve and remain thus with up to 85% of the patients found to respond positively to an average of 10-15 sessions of CBT.
Treatment for Panic Disorder
Treatment for panic disorder is available in different settings and levels of care, including outpatient care or residential care. The level of care is dependent upon various factors, such as the severity of the symptoms, level of impairment, the history of the disorder, and the presence of co-occurring mental health disorders. Treatment elements include:
- Using evidence-based psychotherapies such as cognitive behavioral therapy using the panic control treatment protocol, virtual-reality CBT, prolonged exposure therapy, and panic-focused psychodynamic psychotherapy (PFPP)
- Eye movement desensitization reprocessing (EMDR)
- Group therapy, including skills-training group, psychosocial education, and peer support groups
- Medication, including tricyclic antidepressants, MOAIs, SNRIs, and sedatives
- Relaxation techniques using holistic therapies such as mindfulness and yoga
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